An infant with recurrent convulsive seizures of 3 weeks’ duration: Answers

Hypomagnesemia with secondary hypocalcemia

Early diagnosis and appropriate treatment can lead to good neurological and developmental outcomes. Compliance with long-term treatment with magnesium (Mg) supplements orally is critical to avoid abnormalities in neurological and physical development. Our patient is now 41 years old. He is well, and his neurological developmental and growth, −1.89 standard deviation (SD) for age, have been normal. His bone densitometry readings (1.062 g/cm²; Z score = −0.6) have also been normal. With a therapy consisting of a combination of Mg orally and intermittent Mg sulfate IV, his calcium (Ca), phosphate (P) and alkaline leukocyte phosphatase (ALP) levels remained normal. Serum Mg levels were at the low end of the normal range (1.1–1.3 mEq/L). Over the course of 41 years, he has only complained of mild diarrhea with increased bowel movements.